Retinal Detachment

WHAT YOU SHOULD KNOW

Serving much the same purpose as photographic film, the retina captures light entering the eye and converts it to the nerve impulses that allow us to see. If it becomes separated from the underlying tissue at the back of the eye, permanent blindness is a distinct possibility unless the problem is remedied immediately.

Causes

Retinal detachment sometimes follows a break or tear in the retina caused by injury or surgery. It also results from damage incurred from diabetes or severe eye inflammation. It occurs more frequently in older adults. Both eyes may be affected, but rarely at the same time.

Signs/Symptoms

This disorder causes no pain. Your only warning will be floating spots in the field of vision, blurred vision, or flashing lights. As the problem worsens, you may see images as if through a veil.

Care

To avoid permanent damage, you must seek immediate medical attention. Surgery is almost always required to either reattach the retina or change the shape of the eye. Depending upon the nature of the damage, the doctor will correct the problem with either extreme heat (laser surgery) or extreme cold (cryosurgery).

During laser surgery, the beam causes the eye tissue to thicken and clot, allowing the retina to revert to its normal position. In cryosurgery, a probe is cooled to far below freezing by a flow of liquid nitrogen inside the tip. The instrument is then used to coagulate eye tissue just as the laser does.

Risks

If detachment has occurred only around the front edge of the retina, or reattachment occurs within 48 hours of the onset of your symptoms, your vision will most likely return to normal. More extensive damage could result in permanently blurred central, or detail, vision, although you may still be able to regain your full field of view. Without treatment, retinal detachment will eventually result in partial or complete blindness.

WHAT YOU SHOULD DO

Seek Care Immediately If...

• You notice persistent floaters, flashes of light, or blurred vision.

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

You may encounter the following procedures and equipment during your stay.

• Taking Vital Signs: These include your temperature, pulse, blood pressure, and respiration. A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm. These tests may be performed hourly.
• Complete eye exam: This will be done with an instrument called an ophthalmoscope which allows your doctor to see the position of the retina. You will be asked to look directly into the ophthalmoscope, a small hand-held instrument which contains a mirror, several types of lenses, and a light.
• IV: A tube placed in your vein for giving medications or liquids. It will either be capped or have tubing connected to it.
• Blood: Taken from a vein in your hand or the bend in your elbow to be used for testing. Samples may also be drawn from either the wrist or groin.
• Anesthesia: Your doctor will use either local or general anesthesia to deaden pain during the procedure. Local anesthesia is administered by injection or application directly to the eye. General anesthesia will be administered either by injection or inhalation through a tube placed in your windpipe.
• Surgery: Your doctor will decide whether laser therapy or cryosurgery will be needed to reattach the retina. After the operation, the incision is closed with fine sutures, which are usually removed about one week following the surgery.

After You Leave

• Your doctor will probably prescribe pain relievers, which you should not use for longer than seven days after the surgery.
• Administer eyedrops to keep the pupil dilated. Closely follow your doctors instructions regarding the frequency. If you have trouble applying the eyedrops yourself, ask your doctor for advice on doing it, or get someone else to do it for you.
• Wear dark glasses in bright light until you no longer need to keep the pupils dilated.
• You may wish to wear a patch over the eye if the light bothers you.
• It's usually okay to use nonprescription painkillers such as acetaminophen, but check with your doctor first.
• When resting, lie on your back with your head elevated.
• A cold compress will help reduce swelling of your eyelids and surrounding tissues.
• DO NOT rub your eyes.
• Do not bend over.
• Do not strain yourself in any way such as lifting or bowel movements for at least six months following your surgery.
• Avoid vigorous exercise for at least six weeks following surgery. You may resume other normal activities as soon as you feel up to it.
• Do not drive for at least four weeks following surgery.
• Plan to see your ophthalmologist once every three to six months following surgery to ensure that the eye remains healthy. Also, remember that once you have had retinal detachment in one eye, chances are higher of developing it in the other eye.

Call Your Doctor If...

• You experience increased pain, swelling, redness, drainage, or bleeding in the surgical area.
• You become constipated.
• You develop any symptoms of infection, such as a fever or muscle aches.